What is the analgesic range of acupuncture stimulus for treating acute pain?

Introduction

Since the analgesic effect of acupuncture stimulation is derived from different mechanisms depending on the type of pain, it is important to know which acupuncture points to stimulate. In this study, to confirm the effect of acupuncture stimulation on acute pain from a neurological point of view, somatosensory evoked potential and sensory threshold changes were evaluated to identify the nerve range that is affected by acupuncture stimulation on LI4 (Hapgok acupuncture point, of the radial nerve) during acute pain.

Methods

The subjects were 40 healthy men and women aged 19-35 years. The study was designed as a randomly controlled, crossover trial with acupuncture stimulation at LI4 as the intervention. The washout period for acupuncture stimulation was 2 weeks, and the subjects were divided into two groups, i.e., an acupuncture stimulation group and a nonstimulation group, with 10 men and 10 women in each group. Somatosensory evoked potential measurement was carried out for 5 min by alternately applying 2 HZ-pulse electrical stimulation to the thumb and the little finger of the hand acupunctured with a 64-channel electroencephalogram. The verbal rating scale was used before and after each acupuncture stimulation session.

Result and discussion

The results of the study confirmed that the somatosensory evoked potential amplitude value of the thumb was significantly decreased and that the intensity of sensory stimulation corresponding to a verbal rating scale score of 6 was significantly increased only in the thumb after acupuncture stimulation. Therefore, the results show that acupuncture treatment for acute pain is more effective when direct acupuncture stimulation is applied to the painful area.

Effect of the epicardial fat volume on the outcomes after a left atrial posterior wall isolation in addition to pulmonary vein isolation in patients with persistent atrial fibrillation

Background

While the effect of a circumferential pulmonary vein isolation (CPVI) alone is unsatisfactory, that of an additional electrical posterior wall box isolation (POBI) is controversial in persistent atrial fibrillation (PeAF) patients. Increased epicardial adipose tissue (EAT) is associated with higher recurrence rates after AF catheter ablation (AFCA).

Purpose

We investigated the possible effects of a POBI on rhythm outcomes with varying EAT volumes.

Methods

We included 1,187 patients with PeAF undergoing a de novo AFCA (79.6% male, median age 60 years) into two groups including those receiving a CPVI alone (n=687) and those an additional POBI (n=500). The rhythm outcomes at two years post-AFCA were compared in subgroups stratified by the total EAT volume using propensity overlap weighting.

Results

A reduced total EAT volume was linearly associated with more favorable rhythm outcomes for an additional POBI treatment than for a CPVI alone (P for interaction=0.002). Among the patients with smaller EAT volumes (≤116.23 ml, the median value, n=594), an additional POBI was associated with a reduced AF recurrence risk as compared to a CPVI only (weighted hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.56–0.99; weighted log-rank P=0.039). In contrast, among the remaining 593 patients with greater EAT volumes (>116.2 3mL), there was no difference in the AF recurrence risk between an additional POBI and CPVI alone (weighted HR 1.13, 95% CI 0.84–1.52; weighted log-rank P=0.410). Among 185 patients with a repeat ablation, the POBI reconnection rate tended to be higher in the large EAT group (75.0%) than small EAT group (55.4%, P=0.060).

Conclusion

While PeAF patients with a smaller EAT volume averted AF recurrence by an additional POBI after the CPVI, no benefit of the POBI was observed in those with a greater EAT volume. The EAT volume might identify AF patients likely to benefit from linear ablation in addition to the CPVI.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Ministry of Science, ICT & Future Planning (MSIP)Korean Ministry of Health and Welfare

Biopotential changes of acupuncture points by acupuncture stimulation

Background

The energy flow at acupuncture point is important for understanding the mechanism of acupuncture treatment. However, there are few studies on energy at acupuncture point, and related studies have limitation in explaining the energy flow in all meridians. Thus, we aimed to understand the properties of electrical energy at acupuncture point in twelve meridians by measuring the biopotential at acupuncture and non-acupuncture points.

Methods

For each meridian, twenty subjects were participated, and biopotential was measured at five transport points and their adjacent non-acupuncture points. In each subject, both ‘non-stimulation’ and ‘stimulation’ experiments were conducted in random order. The data were analyzed in two parts: biopotential variability and biopotential difference between acupuncture and non-acupuncture points.

Results

The biopotential variability at acupuncture point was increased by acupuncture stimulation, and it was related to the activation of Qi flow by acupuncture stimulation. The biopotential difference between acupuncture and non-acupuncture points was formed in the direction related to the Qi flow theory, and this biopotential difference tended to decrease by acupuncture stimulation.

Conclusion

The study on biopotential can provide a foundation for research on energy flow mechanism of acupuncture stimulation, and it is expected to overcome limitation of qualitative explanation in traditional medicine.

Is Restoration of Hip Center Mandatory for Total Hip Arthroplasty of Protrusio Acetabuli?

Purpose

While initial fixation using a press-fit of the acetabular cup is critical for the durability of the component, restoration of the hip center is regarded as an attributable factor for implant survival and successful outcome. In protrusio acetabuli (PA), obtaining both restoration of the hip center and the press-fit of the acetabular cup simultaneously might be difficult during total hip arthroplasty (THA). We tested the hypothesis that use of a medialized cup, if press-fitted, will not result in compromise of the implant stability and outcome after cementless THA of PA.

Materials and Methods

A total of 26 cementless THAs of 22 patients with PA were reviewed. During THA, press-fit of the cup was prioritized rather than hip center restoration. A press-fit was obtained in 24 hips. A press-fit could not be obtained in the two remaining hips; therefore, reinforcement acetabular components were used. Restoration of the hip center was achieved in 17 cups; 15 primary cups and two reinforcement components; it was medialized in nine cups. Implant stability and modified Harris hip score (mHHS) between the two groups were compared at a mean follow-up of 5.1 years (range, 2-16 years).

Results

Twenty-six cups; 17 restored cups and nine medialized press-fitted cups, remained stable at the latest follow-up. A similar final mHHS was observed between the restored group and the medialized group (83.6±12.1 vs 83.8±10.4, P=0.786).

Conclusion

Implant stability and favorable results were obtained by press-fitted cups, irrespective of hip center restoration. THA in PA patients showed promising clinical and radiological results.

Acupuncture stimulation at HT7 as a non-pharmacological therapy for sleep disorder caused by caffeine administration in rats

OBJECTIVES

Insomnia is one of the most common sleep disorders and is difficult to completely treat because of the undesirable side effects of hypnotics. The present study was designed to investigate the hypnotic effect of acupuncture stimulation at HT7 on caffeine-induced sleep disorders and locomotor activity in rats. We also evaluated neuronal activity changes in the arousal region of the basal forebrain.

METHODS

Rats received intraperitoneal injections of caffeine, and then electroencephalogram power spectrum analysis and locomotor activity measurements were performed. Stimulation at HT7 was performed using a mechanical acupuncture instrument (MAI) before caffeine injection, and its effects on caffeine-induced changes in sleep architecture, locomotor activity and c-Fos expression were examined.

RESULTS

Caffeine injection (7.5 mg/kg) produced a significant decrease in slow-wave sleep and an increase in wake time compared with saline injection. Caffeine injection also increased locomotor activity and c-Fos expression in the medial septum-vertical limb of the diagonal band of Broca (MS-VDB), one of the arousal regions of the basal forebrain. Stimulation at HT7 with the MAI alleviated the caffeine-induced sleep disturbance and the increase in locomotor activity. In addition, MAI treatment at HT7, compared with treatment at a location not corresponding to any traditional acupuncture point, reduced the caffeine-induced increase in c-Fos expression.

CONCLUSION

These results indicate that the hypnotic effect of HT7 acupuncture stimulation on caffeine-induced insomnia was associated with suppression of neuronal activity in the basal forebrain.

Artificial intelligence-predicted poor responders to catheter ablation for atrial fibrillation

Funding Acknowledgements

Type of funding sources: None.

Introduction

Although atrial fibrillation (AF) catheter ablation is effective for rhythm control, in some patients it is hard to maintain sinus rhythm in spite of repeated AF catheter ablation (AFCA) procedures and anti-arrhythmic drugs (AADs). We explored the pre-procedural predictors for poor responders to AFCA and tested whether artificial intelligence (AI) assists the prediction of poor responders in the independent cohort by determining the invasive parameters.

Methods

Among 1,214 patients who underwent AFCA and regular rhythm follow-up for 56.2 ± 33.8 months (59 ± 11 years, 73.5% male, 68.6% paroxysmal AF), we differentiated 92 poor responders defined as those with sustained AF despite repeat AFCAs, AADs, or electrical cardioversion. Using the Youden index, we identified advanced LA remodeling with lower LA voltage under 1.109mV. AI model, which was derived from development cohort using medical record, was applied to predict LA voltage <1.109mV in the independent cohort (n = 634, poor responders = 24) using a grad-cam score.

Results

The patients with lower LA voltage under 1.109mV showed significantly poorer rhythm outcomes (Log-rank p < 0.001). We determined invasive parameter LA voltage by using the multiple variables (age, female sex, AF type, CHA2DS2VASc score, LA dimension, E/em, hemoglobin, PR interval) and achieved relatively good prediction power of AI for LA voltage <1.109mV (AUC = 0.734, sensitivity 0.729, specificity 0.643) in the test cohort. In the independent cohort, the AI model showed good discrimination power for poor responders (AUC 0.751, p < 0.001) by estimating LA voltage, which is an invasive variable. The patients with predicted lower LA voltage (grad-cam score <0) showed poorer rhythm outcome after active rhythm control (Log-rank p < 0.001)

Conclusions

The patients with advanced atrial remodeling with low LA voltage, which can be predicted by an AI, showed significantly higher recurrence of AF after AFCA with AADs or cardioversion. AI may assist to select these poor responder patients before the AFCA procedure. Abstract Figure.

Left atrial wall stress and the outcome of catheter ablation for atrial fibrillation: artificial intelligence-based prediction of clinical outcome

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction: Left atrial (LA) wall stress (LAW-str) may contribute to the mechanism of atrial fibrillation (AF).

Purpose

We explored the clinical characteristics and the rhythm outcome of AF depending on LAW-str among the patients who underwent AF catheter ablation (AFCA). We also tested whether artificial intelligence (AI) properly estimate LAW-str without invasive parameters.

Methods

We included 2223 patients (72.8% male, 59.0 [52.0–67.0] years old, 28.7% with persistent AF [PeAF]) who underwent radiofrequency catheter ablation (RFCA). LAW-str was calculated by the Law of Laplace using LA diameter (echocardiogram), peak LA pressure, and mean LA wall thickness (computed tomography) measured by customized software. Based on the quartile (Q1–4) or AI-estimated values of LAW-str, we compared clinical characteristics and rhythm outcome.

Results

LAW-str was independently associated with PeAF (p < 0.001), diabetes (p = 0.012) and vascular disease (p = 0.002), body mass index (p < 0.001), E/Em (p < 0.001), and mean LA voltage (p < 0.001). During 26.0 (12.0–52.0) months follow-up, clinical recurrence of AF was significantly higher in the Q4 of LAW-str group (log rank p = 0.001). LAW-str was independently associated with clinical recurrence after AFCA (HR 1.001 [1.000–1.002], p = 0.013). AI-based model using non-invasive parameters predicted Q4 of LAW-str with area under the curve (AUC) 0.734, which was similar to logistic regression based predictive model using all data including invasive parameters (AUC 0.726). Patients in Q4 of LAW-str showed consistently worse rhythm outcome regardless of the type of AF, sex, or AI-based prediction (p = 0.039).

Conclusions

The LAW-str seems to be associated with rhythm outcome of AFCA and AI can predict this complex parameter with moderate accuracy. TableMultivariateβ (95% CI)PPersistent AF31.08 (21.77-40.39)<0.001Diabetes mellitus15.36 (3.35-27.38)0.012Vascular disease22.27 (8.4-36.14)0.002Body mass index2.91 (1.53-4.29)<0.001E/Em4.95 (3.87-6.02)<0.001Mean LA voltage-22.24 (-27.96–16.52)<0.001Linear regression analysis for clinical variables predictive of LA wall stress (10^3 dyn/cm2).Abstract Figure. AF recurrence by LAW-str, AI-prediction

Lipidomics reveals that acupuncture modulates the lipid metabolism and inflammatory interaction in a mouse model of depression

Depression is a serious disease that has considerable impact on lipid metabolism and inflammatory responses. Recent studies have shown that leptin, which is well known as a mediator of energy homeostasis and is a cytokine in inflammatory response, plays an important role in depression. Acupuncture is widely used to treat depression; however, the underlying mechanisms and the effect of acupuncture on depression remain poorly understood. In this study, we utilized the chronic restraint stress (CRS) induced depression model and acupuncture treatment was performed at KI10, LR8, LU8, LR4 (AP) or non-acupoint (NP). Then, lipidomics was applied to investigate the effects of acupuncture on lipid metabolism and analyze leptin signals in the brain and changes of immune markers. Acupuncture treatment at AP improved depression-like behavior in an open-field test, forced swimming test, and marble burying test. Concurrently, CRS mice treated with AP acupuncture (CRS + AP) had significantly lower levels of aspartate aminotransaminase (AST, liver injury markers) and exhibited different lipid patterns in liver lipidomic profiles. In particular, triglycerides (TGs) contributed the change of lipid patterns. Compared to the CRS mice, TGs with relatively high degrees of unsaturated fatty acids increased in the CRS + AP mice, but did not change in CRS mice treated with NP acupuncture (CRS + NP). The levels of leptin in plasma and leptin receptor positive cells in the brain (hypothalamus and hippocampus) decreased and increased, respectively, in the CRS + AP mice, while opposite patterns were exhibited in the CRS and CRS + NP mice. These results indicated that acupuncture treatment at AP attenuated leptin insensitivity in CRS mice. Additionally, expression of pro-inflammatory cytokines such as interleukin-1 beta and tumor necrosis factor-alpha were decreased in the spleen, plasma, and liver of CRS + AP mice, which was one of results of alleviation of leptin resistance. In conclusion, these results show that AP acupuncture treatment effectively alleviated the depression-like behavior, affected immune responses, and altered hepatic lipid metabolism through the attenuation of leptin insensitivity.

Quality of moxa wool contained in commercial moxibustion devices: test method and examples of waste particle concentration

BACKGROUND

Moxibustion treatment involves a combination of thermal and chemical stimulation applied by the combustion of moxa wool. The quality of moxa wool is considered to be an important factor in moxibustion treatment traditionally and clinically. However, despite its importance, quantitative and objective methods for determining moxa wool quality are lacking.

METHODS

Moxa wool and commercial indirect moxibustion (CIM) device specimens were randomly collected, dried and strained through sieves of various sizes for 10 h. After sieving, the residues remaining on each sieve were collected. The collected samples were weighed and microscopically observed.

RESULTS

In this study, we observed that fibres mainly remained on sieves sized 425 μm, and particles were smaller than 300 μm. The residues between 425 and 300 μm varied between the products. In addition, moxa wool for direct moxibustion (DMW) exhibited significantly more fibres than moxa wool for indirect moxibustion (IMW). Most of the CIM devices using moxa wool had a quality similar to IMW, except for one CIM brand using moxa wool that contained three times more waste particles than IMW.

CONCLUSION

Based on the results of this study, we conclude that the sieving method is useful for testing the quality of moxa wool even after the CIM manufacturing process. The sieve sizes of 425 and 300 μm could be used as a yardstick to determine the quality of moxa wool. Although this approach requires larger scale validation against existing standard methodologies, we believe it has great potential to be used to improve and safeguard the quality of moxa wool contained in commercial moxibustion devices.

What is the source of pressure pain during abdominal examination in Korean medicine?

Background

This study aimed to observe which anatomical structures change in the abdominal cavity and are involved in pressure pain during the pressurization of CV12 by using an ultrasonic diagnostic device in healthy subjects.

Methods

We recruited 52 healthy people and performed ultrasound imaging by gradually pressurizing the subject's CV12. We analyzed ultrasound images to observe the changes in abdominal anatomical structures during pressurization.

Results

A significant change in thickness appeared at the space above the peritoneum and stomach and at the space between the stomach and the abdominal aorta while pressing on CV12. Pressure pain occurred in the following two cases. One was when from the posterior side of the stomach to the inner surface of the rectus abdominis became approximately 1.8 cm. The other was when the anterior side of the abdominal aorta approached the inner surface of the rectus abdominis by approximately 3 cm. Pressure pain occurred when CV12 was pressed to a depth of approximately 2.4 cm for females, 3.1 cm for males and 2.7 cm on average.

Conclusion

The stomach and tissues around the stomach undergo the greatest pressure change during the pressurization of CV12, and in particular, pressure pain occurs when the posterior wall of the stomach is under pressure. However, further study should be done for clinical application.

Biological safety of Electroacupuncture with STS316 needles

Background

Electroacupuncture (EA) is often used in clinical settings due to its analgesic effect, but its safety has not been verified due to the lack of clear criteria. This study examined the critical range of the corrosion of stainless steel types STS304 and STS316, which have been used clinically, and the relationship between needle corrosion and cell necrosis.

Method

The critical point of corrosion for STS304 and STS316 was identified by varying the time, frequency, and stimulation intensity. In a tissue necrosis experiment, EA stimulation was applied to rats using STS316 needles with different thicknesses at maximum intensity for 60 min, and the presence of corrosion and tissue necrosis was determined. A cytotoxicity experiment was also conducted and assessed the needles and tissue necrosis.

Results

The results showed that STS316 was more stable than STS304 and that only coated needles corroded. Furthermore, tissue necrosis was observed regardless of corrosion, and slight cell necrosis was associated with needles with corrosion.

Conclusions

This study demonstrated that non-coated STS316 was the most stable for EA stimulation and that corrosion byproducts and cell necrosis were not directly related.

A mechanical acupuncture instrument mitigates the endoplasmic reticulum stress and oxidative stress of ovariectomized rats

Background

Acupuncture has become a common complementary and alternative treatment approach for anxiety and depression. However, there is little research on the detailed mechanism of acupuncture therapy relieving depression. Previously, 17β-estradiol (E2) was shown to prevent oxidative stress and endoplasmic reticulum (ER) stress in ovariectomized (OVX) rats. This study investigated whether stimulation of Sanyinjiao (SP6) using a mechanical acupuncture instrument can alleviate depression-like behavior caused by estrogen deficiency in OVX rats. Furthermore, we found that acupuncture reduced ER stress and oxidative stress-related proteins expression.

Methods

The OVX operation was performed on female SD rats that were separated into four groups: The E2 (2.5 μg/kg, i.p.) injection group (OVX + E2), the OVX group (OVX), and the OVX with acupuncture stimulation group (OVX + SP6). Non-acupoint stimulation group (OVX + NonAcu). The acupuncture point stimulation began three weeks after surgery. The depressive behavior was analyzed by the forced swim test and open field test. The 8-OHDG, BiP, Sigma receptor 1, pJNK, PDI, Ero1-Iα and Calnexin protein levels were evaluated by immunoreactivity in the amygdala.

Results

Acupuncture stimulation reduced depressive behavior and altered depression-related proteins. Stimulation of SP6 decreased the immobility time of the FST and altered the ER stress and oxidative stress marker proteins, such as 8-OHDG, BiP, pJNK, PDI, Ero1-Ia and Calnexin.

Conclusion

Our results indicated that acupuncture at SP6 showed a significant antidepressant-like effect on an OVX-induced depression rat model by mitigation of ER stress and oxidative stress in amygdala.

Peripheral Sensory Nerve Tissue but Not Connective Tissue Is Involved in the Action of Acupuncture

Acupuncture has been used to treat a variety of diseases and symptoms for more than 2,500 years. While a number of studies have shown that nerves are responsible for initiating the effects of acupuncture, several lines of study have emphasized the role of connective tissue in the initiation of acupuncture signals. To determine whether nerves or connective tissue mediate the action of acupuncture, we constructed a robotic acupuncture needle twister that mimicked the twisting of the needle by an acupuncturist, and we examined the role of nerves and connective tissues in the generation of acupuncture effects in rat cocaine-induced locomotion, stress-induced hypertension, and mustard oil-induced visceral pain models. Robotic or manual twisting of acupuncture needles effectively suppressed cocaine-induced hyperactivity, elevated systemic blood pressure or mustard oil-induced visceral pain in rats. These acupuncture effects were completely abolished by injecting bupivacaine, a local anesthetic, into acupoints. However, disruption of connective tissue by injecting type I collagenase into acupoints did not affect these acupuncture effects. Our findings suggest that nerve tissue, but not connective tissue, is responsible for generating the effects of acupuncture.

An estradiol-independent BDNF-NPY cascade is involved in the antidepressant effect of mechanical acupuncture instruments in ovariectomized rats

Menopause-related depression devastates women's quality of life after middle age. Previous research has shown that estrogen hormone therapy has serious adverse effects; thus, complementary and integrative therapies have been considered clinically. The present study investigates whether stimulation of an acupoint using a mechanical acupuncture instrument (MAI) can mitigate depression-like behavior caused by estrogen deficiency in ovariectomized (OVX) rats. The animals were divided into Sham OVX, OVX, OVX + Sameumgyo (SP6) and OVX + NonAcu (non-acupuncture point) groups. MAI stimulation significantly increased the total distance traveled in the open-field test and the number of open-arm entries in the elevated plus maze and decreased the duration of immobility in the forced swim test. In addition to this decrease in depression-like behavior, brain-derived neurotrophic factor (BDNF) and neuropeptide Y (NPY) release increased in the hippocampus in response to MAI treatment, but estradiol levels did not recover. Furthermore, microinjection of the BDNF receptor antagonist ANA-12 (0.1 pmol/1 μl) into the hippocampus before MAI stimulation significantly suppressed the recovery of NPY levels. Taken together, these findings indicate that MAI stimulation at SP6 facilitates an estradiol-independent BDNF-NPY cascade, which may contribute to its antidepressant effects in OVX rats, an animal model of menopausal disorders.

Trends in deqi research: a text mining and network analysis

Background

Deqi is a term describing a special state of the human body, which is ready to cure itself through acupuncture stimulation and is believed to be a key factor in acupuncture treatment. However, knowledge about deqi remains subjective. Therefore, in this study, we aimed to determine the factors related to deqi generation based on present studies to promote the progression of deqi research.

Methods

A term frequency–inverse document frequency (Tf-idf) was used to extract key elements from the abstracts of 148 articles searched from Pubmed, and the network structure between key elements was analyzed.

Results

A total of 37 items were extracted from the abstracts. Each item was categorized into one of three groups (acupuncture-related sensation, interventions or organ/mechanism). Acupuncture-related sensation was studied by comparing the items in the interventions group with the organ/mechanism group. Key elements related to deqi generation included muscles from the organ/mechanism group and intensity, depth and pressure from the interventions group. Items that belonged to the acupuncture-related sensation group were divided into two clusters: one cluster consisted of pain, tingling, aching, soreness, heaviness, fullness and numbness; the other included warm, cold and dull.

Conclusion

We could find out that the trend of deqi was leaning towards the interventions group, which related to the generation of deqi; thus, authors concluded that the mechanism studies, which are aimed to investigate why deqi is generated or what kind of meanings it has, are needed for evolution of acupuncture theory and application of the brand new technologies and related devices.

Change in the P300 index - a pilot randomized controlled trial of low-frequency electrical stimulation of acupuncture points in middle-aged men and women

Background

The P300 is a major index used to evaluate improvements in brain function. Although a few studies have reported evaluating the effectiveness of manual acupuncture or electro-acupuncture by monitoring the P300, research in this field is not yet very active. The aim of this study was to investigate the effects of periodic low-frequency electrical stimulation applied to BL62 and KI6 on brain activity by analyzing the P300.

Method

The study was conducted as a randomized double-blind test of 55 subjects in their 50s, including 26 males and 29 females. Each subject received 12 sessions of stimulation over a one-month period. In each session, low-frequency electrical stimulation at an average of 24 μA and 2 Hz was applied to the acupuncture points BL62 and KI6, and event-related potentials (ERPs) were measured before the first session and after the last session of the electrical stimulation.

Results

The results of a chi-square test indicated that the double-blind test was conducted correctly. Compared to the Sham group, all the subjects in the Real stimulation group showed a tendency toward a decreasing P300 latency and increasing P300 amplitude after all 12 sessions of stimulation. In the women, the amplitude significantly increased at Fz, Fcz, Cz, Cpz, and Pz.

Conclusions

With this experiment, the low-frequency electrical stimulation of two acupuncture points (BL62 and K16) was confirmed to have a positive influence on the prevention of natural cerebral aging.

Trial registration

This study was registered at the Clinical Research Information Service (CRIS) of the National Research Institute of Health (https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?, Registration Number: KCT0001940). The date of registration was June 9, 2016.

Development of electromyographic indicators for the diagnosis of temporomandibular disorders: a protocol for an assessor-blinded cross-sectional study

Background

Noninvasive and easy-to-use surface electromyography (EMG) is frequently utilized for the diagnosis of temporomandibular disorders (TMDs). However, few EMG parameters that consider TMDs in addition to the cranio-cervical-mandibular system have been regarded as important in traditional Korean medicine.

Methods

This clinical trial will be conducted as an assessor-blinded cross-sectional study. The participants will be classified based on the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/TMD SQ) and 30 TMD patients and 30 healthy controls will be enrolled. The primary outcome will be the percentage overlapping coefficient (POC; %) in the masseter and sternocleidomastoid muscles between the patient group and healthy control group in clenching and cervical side flexion. The secondary outcomes include the score from temporomandibular joint-related questionnaires, the difference in the absolute values of EMG for the healthy group and TMD group before/after wearing intraoral appliances, and the change in the location of the temporomandibular joint as determined by X-ray imaging and 3D face photography.

Discussion

This study will provide information about the objective diagnostic method for TMD using surface EMG and will verify the effectiveness of surface EMG in diagnosing TMD. Furthermore, the method or device for diagnosis TMD will improve the expansion of treatment area to TMD by accumulating evidence for the efficacy of TKM treatment.

Safety recommendations for moxa use based on the concentration of noxious substances produced during commercial indirect moxibustion

BACKGROUND

Moxibustion therapy has been used historically for thousands of years and there are many clinical trials supporting its efficacy and effectiveness for various conditions. Moxa smoke has been a major reason for avoiding moxibustion due to its smell and potential risks to the human body.

METHODS

10 units of commercial indirect moxa (CIM) from six manufacturers (A-F) were burnt in a 2.5×2.5×2.5 m chamber without ventilation, and concentrations of carbon oxides (CO and CO₂), nitrogen oxides (NOx), and volatile organic compounds (VOCs) from the indoor air samples were measured.

RESULTS

For brands A, B, C, D, E, and F, respectively, relative to baseline values, we observed an increase in CO (from 0.002 to 0.007, 0.006, 0.005, 0.006, 0.005, and 0.006 parts per billion (ppb)), NOx (from 0.009 to 0.051, 0.025, 0.015, 0.050, 0.019, and 0.020 ppb), and total VOCs (TVOC; from 48.06 to 288.83, 227.93, 140.82, 223.22, 260.15, and 161.35 μg/m³), while the concentration of CO₂ was not elevated. Each CIM brand demonstrated different VOC emission characteristics, which could be divided into three groups. On average, we estimated that 20 units of CIM or 2.41 g moxa floss would need to be combusted in order to exceed the safe levels set by Korean environmental law. This limit is likely to be greater in the case of a larger room or use of ventilation.

CONCLUSIONS

Despite increased CO/NOx/VOC concentrations, overall levels remained within safe limits. These findings may help clinicians to maintain safe moxibustion treatment conditions to help keep both patients and clinicians safe from the pollutants generated by moxa combustion.

Exploration of differentiation standard for primo through the histological common point of threadlike structure found in rats and swine

BACKGROUND

The novel threadlike structure is called the primo structure, and studies are conducted through many different approaches. Although various ways of differentiation are currently used, a standard for differentiation is deemed necessary in order to identify the primo structure based on the overall form of the structure. This study aims to explore the differentiation standard through the histological common point of the threadlike structure of rat and swine by using the hematoxylin and eosin (H&E) staining method commonly used for histological research in various structures.

METHODS

An 8-week old Sprague-Dawley rat and a Yorkshire pig weighing 30-40 kg were used. A total of 65 pieces of rat threadlike structure and 100 pieces of swine threadlike structure were collected after the abdomen was cut and opened. The following three different characteristics were confirmed using the H&E staining method for the collected structures: (1) bright cell availability; (2) cavity availability; and (3) nuclei density.

RESULTS

For the rat threadlike structure, the bright cell (70.5%) and nuclei density (92.6%) were mainly observed; in the swine threadlike structure, however, the bright cell (60.6%) and cavity (67.2%) were mainly observed. The bright cell was confirmed to have been observed in the threadlike structures of both rat and swine.

CONCLUSION

The bright cell is determined to be the common point in the primo structure. However, further research is deemed necessary in the future as to the functions performed by the characteristic shown by the Primo structure.

Histological similarity of primo vascular systems derived from three internal organs of rats

BACKGROUND

The primo vascular system has been suggested as the third circulatory system. Although primo tissues have been observed in various tissues isolated from a number of animal species, including mice, rats, and rabbits, very few reports on the histological characteristics of primo tissues from different body parts are available. This study was designed to compare the histological characteristics of primo tissues isolated from different body parts of rats.

METHODS

Rats were anesthetized and operated on, to locate primo tissues. The primo tissues were searched at the all organs' surface and in lymphatic vessels using suitable finding methods. The tissues found were then separated and observed by histological test methods.

RESULTS

This histological study revealed that there was no difference between the histological characteristics of the organ-surface primo tissues, the primo tissues inside lymphatic vessels, and the primo tissues on the falciform ligament. Moreover, primo tissues could be differentiated from those with a similar structure, such as lymphatic vessels and blood vessels, by immunostaining against a-LYVE-1 and a-CD31, and can be observed by specific immunostaining against the Von Willebrand factor (vWF).

CONCLUSION

The results of this study support the fact that primo tissues could possibly constitute a third circulatory system in the whole-body network.

Delayed presentation of osteochondroma on the ventral surface of the scapula

Osteochondroma is a cartilage-covered bony excrescence that arises from the surface of a bone. It is the most common benign bone tumor in the scapula and can also present as multiple masses in multiple hereditary exostosis. A solitary scapular lesion might lead to "snapping scapula" syndrome, which is characterized by a sometimes audible but usually palpable grinding sensation experienced with scapular abduction. Snapping scapula is usually painless without specific symptoms; however, discomfort may result from the mechanical effects of a ventral scapular mass projecting onto a normally smooth, gliding scapulothoracic joint. Furthermore, malignant transformation of the cartilaginous cap, by virtue of the increased mass, may precipitate symptoms. The visual deformities and interference with major joint function are the most frequent musculoskeletal complaints related by patients. Indications for operative intervention include painful mechanical dysfunction unresponsive to conservative measures and sarcomatous change. Ventral scapular osteochondromas have been reported to cause scapular asymmetry and should be ruled out as part of a differential diagnosis to a "winged" scapula. A solitary osteochondroma can be excised either by arthroscopic or by open means, with the size of the lesion dictating precise management. Scapular osteochondromas usually are detected early during maturation due to mechanical symptoms or gross deformity. Unfortunately, most require surgical excision. Most surgical excisions have been reported in adolescents and young adults. We report an unusual case of osteochondroma from the ventral surface of the scapula in 56-year-old woman who had experienced delayed onset mechanical symptoms which required surgical excision.

Electrical characteristic analysis using low-frequency noise in low-temperature polysilicon thin film transistors

This study carried out an electrical characteristic analysis using low-frequency noise (LFN) in top gate p-type low-temperature polysilicon thin film transistors (LTPS TFTs) with different active layer thicknesses between 40 nm and 80 nm. The transfer characteristic curves show that the 40-nm device has better electrical characteristics compared with the 80-nm device. The carrier number fluctuation, with and without correlated mobility fluctuation model in both devices, has modeled well the measured noise. On the other hand, the trap density and coulomb scattering in the 40-nm device are smaller compared with the 80-nm device. To confirm the effectiveness of the LFN noise analysis, the trap densities at a grain boundary are extracted using in both devices the similar methods of Proano et al. and Levinson et al. That is, coulomb scattering, caused by the trapped charges at or near the interface, has a greater effect on the device with inferior electrical properties. Based on the LFN and the quantitative analysis of the trap density at a grain boundary, the interface traps between the active layer and the gate insulator can explain the devices' electrical degradation.

Caspase-3 activation as a key factor for HBx-transformed cell death

OBJECTIVES

Nuclear factor-kappa B (NF-kappaB) activation has been associated with the tumorigenic growth of hepatitis B virus X protein (HBx)-transformed cells. This study was aimed to find a key target for treatment of HBx-mediated cancers.

MATERIALS AND METHODS

NF-kappaB activation, endoplasmic reticulum-stress (ER-stress), caspase-3 activation, and cell proliferation were evaluated after Chang/HBx cells permanently expressing HBx viral protein were treated with inhibitors of NF-kappaB, proteasome and DNA topoisomerase.

RESULTS

Inhibition of NF-kappaB transcriptional activity by transient transfection with mutant plasmids encoding Akt1 and glycogen synthase kinase-3beta (GSK-3beta), or by treatment with chemical inhibitors, wortmannin and LY294002, showed little effect on the survival of Chang/HBx cells. Furthermore, IkappaBalpha (S32/36A) mutant plasmid or other NF-kappaB inhibitors, 1-pyrrolidinecarbonidithioic acid and sulphasalazine, were also shown to have little effect on the cell proliferation. By contrast, proteasome inhibitor-1 (Pro1) and MG132 enhanced the HBx-induced ER-stress response and the subsequent activation of caspase-12, -9 and -3 and reduced cell proliferation. Camptothecin (CPT), however, triggered activation of caspase-3 without induction of caspase-12, and reduced cell proliferation. In addition, CPT-induced cell death was reversed by pre-treatment with z-DEVD, a caspase-3-specific inhibitor.

CONCLUSIONS

Detailed exploitation of the regulators of caspase-3 activation could open the gate for finding an efficient target for development of anticancer therapeutics against HBx-transformed hepatocellular carcinoma.

Pharmacokinetics and metabolism of acriflavine in rats following intravenous or intramuscular administration of AG60, a mixture of acriflavine and guanosine, a potential antitumour agent

Acriflavine (ACF; CAS 8063-24-9), a mixture of trypaflavine (TRF) and proflavine (PRF) at a ratio of 2:1 is being investigated in rodents as an anticancer agent. However, its pharmacokinetics have not been investigated in mammals. Guanosine is known to potentiate the anticancer activity of some compounds. The pharmacokinetics of AG60, a 1:1 mixture of ACF and guanosine, were therefore investigated in rats. Rats were given 2 or 10 mg kg(-1) AG60 by intravenous bolus or 6 or 30 mg kg (-1) intramuscularly. An HPLC-based method was developed to analyse the levels of TRF, PRF, and their metabolites in plasma, bile, urine and tissue homogenates. The plasma concentrations of TRF and PRF decreased rapidly after intravenous administration and more slowly after intramuscular administration. Both TRF and PRF were distributed widely, most notably in the kidney, and were eliminated slowly. Three glucuronosyl conjugate metabolite peaks were tentatively identified in the bile. The intramuscular route leads to a prolongation of TRF or PRF plasma levels, and the systemic exposures for both TRF and PRF were both relatively high. These observations indicate that the intramuscular route may be the best way to administer AG60 for various clinical applications.

Human hair growth enhancement in vitro by green tea epigallocatechin-3-gallate (EGCG)

Green tea is a popular worldwide beverage, and its potential beneficial effects such as anti-cancer and anti-oxidant properties are believed to be mediated by epigallocatechin-3-gallate (EGCG), a major constituent of polyphenols. Recently, it was reported that EGCG might be useful in the prevention or treatment of androgenetic alopecia by selectively inhibiting 5alpha-reductase activity. However, no report has been issued to date on the effect of EGCG on human hair growth. This study was undertaken to measure the effect of EGCG on hair growth in vitro and to investigate its effect on human dermal papilla cells (DPCs) in vivo and in vitro. EGCG promoted hair growth in hair follicles ex vivo culture and the proliferation of cultured DPCs. The growth stimulation of DPCs by EGCG in vitro may be mediated through the upregulations of phosphorylated Erk and Akt and by an increase in the ratio of Bcl-2/Bax ratio. Similar results were also obtained in in vivo dermal papillae of human scalps. Thus, we suggest that EGCG stimulates human hair growth through these dual proliferative and anti-apoptotic effects on DPCs.

An algorithm to detect a center of pupil for extraction of point of gaze

This work proposes an algorithm that is developed for the video-oculograph method. It is used to detect a center of pupil for extraction of point of gaze in the eye image acquired by a charge coupled device camera and TV receiver card. The center of pupil could be detected accurately by applying the proposed algorithm in this study that removes noise effectively caused by eyelashes and image that is projected on pupil. In this study, we assume that the pupil is a perfect circle in the captured eye images.

Skin problems after a tsunami

BACKGROUND

On December 26, 2004, the biggest earthquake for 40 years, measuring 9.0 on the Richter scale, triggered a tsunami that pounded the coastal areas of South Asia and East Africa. The effects of the tsunami on skin conditions have not been evaluated.

OBJECTIVE

To determine the influence of the tsunami on skin conditions by evaluating the skin problems of patients presenting at hospitals after the tsunami.

METHODS

Between 5 and 25 January 2005, two dermatologists evaluated patients who complained of skin problems at an outpatient clinic and emergency room of a general hospital in Banda Aceh, Aceh Province, Indonesia.

RESULTS

The total number of patients that presented during the study period was 235 (131 males and 104 females), and they had a total of 265 skin problems. In terms of age distribution, most subjects were in their fourth decade (23.0%), followed by the third (22.6%) and fifth decade (16.6%). The most prevalent skin problems were infections-infestations (32.5%), followed by eczemas (29.8%) and traumatic skin disorders (29.4%). In males, traumatic skin disorders were most common. The great majority of infection-infestation cases involved superficial fungal infections. Contact dermatitis accounted for three-quarters of eczema cases, and mainly involved the arms (40.0%) and legs (27.1%). The majority of traumatic skin disorders were lacerations, punctures and penetrations, and the feet (44.7%) and hands (18.8%) were most frequently affected.

CONCLUSIONS

Unhygienic conditions, exposure to a hazardous environment and contact with various objects during and after the tsunami probably increased the prevalence of infections-infestations, traumatic skin disorders and contact dermatitis. To prevent these problems and associated secondary bacterial infections, health-related education and early medical management are required.

Ethnic characteristics of eyelashes: a comparative analysis in Asian and Caucasian females

BACKGROUND

Despite similar biochemical composition of human hair between races, physico-morphological characteristics are not identical in different ethnic groups. Eyelashes have been investigated far less than scalp hair, and the information available is insufficient.

OBJECTIVES

To obtain basic information about eyelashes and to clarify differences between female eyelashes in Asians and Caucasians.

METHODS

Twenty Asian and 10 white Caucasian female volunteers aged between 20 and 29 years were admitted to the study. Lateral digital photographs of upper eyelashes were taken and curl-up and lift-up angles of upper eyelashes were measured from lateral views. Images of upper eyelashes were also taken using the phototrichogram technique and total numbers, lengths and thicknesses of upper eyelashes were obtained (a total of 4661 eyelashes; 2946 for Asian, 1715 for Caucasian). The central portion of the eyelashes or whole eyelashes were clipped and images were taken immediately and 7 days later to obtain the growth rate and anagen ratio of upper eyelashes. Numbers and thickness of eyelash cuticular layers were obtained by electron microscopy.

RESULTS

Compared with Caucasians, Asian eyelashes revealed lower lift-up and curl-up angles, fewer numbers and a thicker transverse diameter. However, no statistical difference was observed in length or growth rate. Duration of anagen was estimated at about 2 months. The eyelash anagen ratio obtained from five Asians was 17.8 +/- 3.3%. By electron microscopy, the number of cuticular layers in transverse section was greater in Asian (8.0 +/- 1.2) than Caucasian females (6.5 +/- 1.1), but no statistical difference was found in single cuticle layer thickness between the two groups. Moreover, eyelash characteristics were not influenced by eye makeup in either race.

CONCLUSIONS

Our results on eyelash morphology and growth characteristics demonstrated significant ethnic differences in Asian and Caucasian females that could provide basic information for future investigations.

Effects of feeding antibiotic-free creep feed supplemented with oligofructose, probiotics or synbiotics to suckling piglets increases the preweaning weight gain and composition of intestinal microbiota

The objective of this study was to determine whether feeding an antibiotic-free creep feed supplemented with either oligofructose, probiotics or synbiotics to suckling piglets influences growth performance, the gut microflora, gut morphology and hematological traits at weaning. Twenty sows with 10 piglets each were randomly assigned to one of four treatments. The treatments consisted of a control (antibiotic-free) diet, 0.2% oligofructose (OF), 0.3% probiotics or 0.5% synbiotics (mixture of 0.2% OF+0.3% probiotics). Piglets were offered the diet ad libitum from 7 d after birth until one day after weaning (21 d of age). At the day after weaning, blood samples were collected from the jugular vein to determine the immune response. Digesta samples of the ileum and colon were collected to determine the microbial composition. Tissue segments from the duodenum and ileum were collected for morphometric measurements of the small intestine. The average daily weight gain was significantly higher for piglets fed the OF or synbiotics diet compared with the pigs fed the control diet. The hematological traits (the concentration of lymphocytes and neutrophils in whole blood) were not affected by the diet. Piglets fed the OF, probiotics or synbiotics diet had a significantly decreased number of total coliform bacteria in the colon. Feeding OF, probiotics or synbiotics significantly increased the population of bifidobacteria in the ileum compared to the control. In the colon, the probiotics and synbiotics diet significantly increased the number of bifidobacteria compared with the control diet. The results of this experiment showed that supplementation of oligofructose or synbiotics to an antibiotic-free creep feed during the preweaning period affected gut microbial population and performance of piglets.

Prognostic significance of glycaemic control in patients with HBV and HCV-related cirrhosis and diabetes mellitus

AIMS

Diabetes mellitus (DM) is frequently observed in patients with cirrhosis, particularly that due to hepatitis C virus (HCV) infection. However, no studies have focused on the clinical significance of glycaemic control in cirrhotic patients because of their short life expectancy and poor hepatic function. The aim of this study was to evaluate the prognostic impact of glycaemic control in patients with hepatitis B virus (HBV) and HCV-related cirrhosis and DM.

METHODS

A total of 434 patients with HCV-related (HCV group, n = 88) or HBV-related (HBV group, n = 346) cirrhosis were studied retrospectively. We determined the prevalence of DM and treatment methods for hyperglycaemia and status of glycaemic control, and the patients' outcome.

RESULTS

The prevalence of DM was 43.2% (38/88) in the HCV group and 19.7% (68/346) in the HBV group. Patients in the HCV group were older with a female preponderance. DM was detected before the diagnosis of cirrhosis or simultaneously in 92% and 79% in the HCV and HBV groups, respectively. Most patients were treated with insulin or oral hypoglycaemic agents. However, blood glucose levels were maintained within the normal range in 34.2% of the HCV group and in 23.5% of the HBV group. Forty-six patients died during the observation period in both groups. Hepatic failure was the most common cause of death, and sepsis and variceal bleeding were more frequent in the HCV group than in the HBV group. Multivariate analysis showed that Child-Pugh class was the most important factor for survival in both groups. In the HCV group, the status of glycaemic control was a significant independent factor of survival (P = 0.018). In the HBV group, age and the development of spontaneous bacterial peritonitis were significant.

CONCLUSION

DM is more frequent in patients with HCV-related cirrhosis than in patients with HBV. Strict control of blood glucose levels could improve survival in HCV patients. A precise assessment of the risks and benefits of glycaemic control is required to reduce the mortality and morbidity of patients with cirrhosis and DM.

Molecular cloning of levan fructotransferase gene from Arthrobacter ureafaciens K2032 and its expression in Escherichia coli for the production of difructose dianhydride IV

AIMS

To clone and overexpress a novel levan fructotransferase gene lftA from Arthrobacter ureafaciens K2032.

METHODS AND RESULTS

The lftA gene, encoding a levan fructotransferase (LFTase) of 521 amino acids (aa) residues, was cloned from the genomic DNA of A. ureafaciens K2032, and overexpressed in Escherichia coli. The recombinant LFTase overexpressed in E. coli was then used to produce a difructose dianhydride (DFA IV) from levan. DFA IV crystals with 97% purity could be obtained from the reaction mixture in 83.7% yield by using a natural crystallization method.

CONCLUSIONS

The lftA gene cloned from A. ureafaciens K2032 encode a novel levan fructotransferase which produces difructose dianhydride (DFA IV) from levan.

SIGNIFICANCE AND IMPACT OF THE STUDY

Levan fructotransferase is a useful enzyme with great promise in the production of DFA IV and various fructosides.

Cloning and expression of a novel esterase gene cpoA from Burkholderia cepacia

AIMS

To screen and clone a novel enzyme with specific activity for the resolution of (R)-beta-acetylmercaptoisobutyrate (RAM) from (R,S)-beta-acetylmercaptoisobutyrate [(R,S)-ester].

METHODS AND RESULTS

A micro-organism that produces a novel esterase was isolated and identified as the bacterium Burkholderia cepacia by using the analysis of cellular fatty acids, Biolog automated microbial identification/characterization system, and 16S rRNA gene sequence analysis. A novel esterase gene was cloned from the chromosomal DNA of B. cepacia and was designated as cpoA. The cpoA encodes a polypeptide of 273 amino acids which shows a strong sequence homology with many bacterial nonhaeme chloroperoxidases. In addition, a typical serine-hydrolase motif, Gly-X-Ser-X-Gly, and the highly conserved catalytic triad, Ser95, Asp224, and His253, were identified in the deduced amino acid sequence of cpoA by multiple sequence alignment.

CONCLUSION

The cpoA cloned from B. cepacia encodes a novel esterase which is highly related to the nonhaeme chloroperoxidases.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report that describes the isolation and cloning of a serine esterase gene from B. cepacia, which is useful in the chiral resolution of (R,S)-ester. The cloned gene will allow additional research on the bifunctionality of the enzyme with esterase and chloroperoxidase activity at the structural and functional levels.

A case of primary adenosquamous carcinoma of the liver presented with liver abscess

Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6 x 5 x 5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.

The temporal alteration of GAD67/GAD65 ratio in the gerbil hippocampal complex following seizure

In the present study, the distribution of glutamic acid decarboxylase (GAD) isoforms in the hippocampus of the Mongolian gerbil and its association with different sequelae of spontaneous seizure were investigated to identify the roles of balance of GAD isoforms in the epileptogenesis and the recovery mechanisms in these animals. The GAD67/GAD65 ratio in the hippocampus of pre-seizure seizure sensitive (SS) gerbil was approximately 3.5-fold higher as compared to seizure resistant (SR) gerbil. Following seizure, this ratio shifted to the level of SR gerbils up to 12 h postical. Therefore, the mismatched GAD67/GAD65 ratio (imbalance of GAD isoform expressions) in the hippocampus of SS gerbil implies that GABAergic neurons may be highly activated in order to regulate the increased neuronal excitability. In addition, the alteration in this ratio after seizure may be the compensatory response for reduction of epileptic activity in this animal.

Effect of diazinon on behavior of Japanese medaka (Oryzias latipes) and gene expression of tyrosine hydroxylase as a biomarker

This paper reports on the development of a biomarker used to monitor abnormal behaviors caused by diazinon in Japanese medaka (Oryzias latipes) as a model organism. Tyrosine hydroxylase (TH) activity in tissues was measured and the TH enzyme production in specific organs using a in situ cytochemical technique was monitored. These data were comparatively analyzed with those from semi-quantitative RT-PCR utilizing medaka TH gene that could be a potential biomarker for neuronal modulations and behaviors. For monitoring experiments at behavioral and molecular biological levels, the fish were treated under different sublethal conditions of diazinon (O, O-diethyl O-[6-methyl-2-(1-methylethyl)-4-pyrimidinyl] phosphorothioate) and their behavioral responses were observed. There were no significant differences in activity of TH head and body portions when the fish were exposed to lower concentrations (0.5-10 ppb) of diazinon including control treatment (0 ppb) for 24 hr. In temporal change of TH activity at 100 ppb diazinon treatment, however, the activity of body portion appeared to be inhibited during the first 30 min exposure but later seemed to recover slightly after 1 hr. TH appeared to be expressed mainly in the olfactory bulb, midbrain and brain stem regions as assessed by in situ immunohistochemistry. The treatment (1000 ppb) significantly suppressed TH protein production in the olfactory bulb, midbrain and brain stem regions. In kidney from the body portion the higher concentration treatment (1000 ppb) caused little suppression compared with the control. The RT-PCR showed that a production of TH mRNA transcript was significantly inhibited at 5 ppm diazinon treatment in the body portion. It was concluded that a suppression of TH activity would be one of the causes for the abnormal behaviors of the medaka that could be quantitatively monitored using an image processing system. This study provides molecular and neurobehavioral bases of a biomonitoring system for toxic chemicals using a model organism such as fish.

Changes of skin blood flow and color on lesional and control sites during PUVA therapy for psoriasis

BACKGROUND

Although the colors of psoriatic lesions, largely determined by erythema and scales, are important clinical indicators, expressing them in an objective manner is difficult. Cutaneous blood flow (CBF) also affects erythema. Serial measurement of these parameters during phototherapy was almost nonexistent.

OBJECTIVE

The objectives of our study were to observe the changes of color parameters and the CBF of psoriatic lesions during PUVA therapy and to determine their clinical significance.

METHODS

CBF, measured by laser Doppler flowmetry, and color parameters, measured by tristimulus colorimetry and reflectance spectrophotometry, were assessed in 13 patients with psoriasis who received PUVA therapy.

RESULTS

The values of CBF, erythema index (EI), and a(*) (color parameter representing red-green axis) in psoriatic lesions were significantly different from those observed in the control sites before therapy. The parameters of psoriatic lesions normalized according to the clinical improvement and approached those of the control sites as PUVA therapy progressed. The values of melanin index (MI), L(*) (color parameter representing white-black axis), and b(*) (color parameter representing yellow-blue axis) showed no significant difference between the psoriatic plaques and the control sites. They all displayed changes toward darkening and indicated tanning induced by PUVA therapy. Serial changes presented a generally unidirectional pattern in the control sites. However, this was not always the case in psoriatic lesions because scale, infiltration, and erythema also affected the measurement of blood flow and the color of the skin.

CONCLUSION

Color parameters and CBF were closely related with clinical improvement according to consecutive phototherapy. They may serve as objective indices for the visible morphology and underlying lesional pathophysiology of psoriasis.

Microbial PCB dechlorination in dredged sediments and the effect of moisture

Evidence of reductive dechlorination of polychlorinated biphenyls (PCBs) in sediments was investigated in Hudson River sediments dredged and encapsulated in 1978 at Moreau, NY. The effect of different moisture contents in dredged sediments on dechlorination and dechlorinating microorganisms was also determined using PCB-spiked sediments in which the moisture level was adjusted by simulating a dewatering process. The congener pattern of PCBs indicated that the dechlorination in the dredged sediments was far less advanced than that in the river sediments collected from the general area of the dredged site (Ft. Edward site). Dechlorination in encapsulated sediments at the Moreau site appeared to have stopped soon after dredging. When microorganisms eluted from the encapsulated sediments were inoculated in clean sediments spiked with Aroclor 1242, an extensive dechlorination was observed, indicating that the encapsulated sediments still harbored dechlorinating microorganisms. However, the same inoculum failed to further dechlorinate residual congeners in the dredged sediments. On the other hand, an inoculum obtained in 1990 from the dredged site in the Hudson River dechlorinated the residual congeners further. In simulated dredged sediments, the maximum level of dechlorination was lower at reduced moisture contents. The population size of dechlorinating microorganisms, as determined by the most probable number (MPN) technique, was also smaller at the lower moisture levels. There was a significant correlation between the maximum extent of dechlorination and the specific death rate of dechlorinating populations. These results indicate that the underlying mechanism of the moisture-dependent maximum dechlorination is the moisture-dependence of the death rate of dechlorinating microorganisms.

Molecular epidemiology of hepatitis A virus in Korea

BACKGROUND

The prevalence of antibodies for hepatitis A virus (anti-HAV) in adolescents and young adults has decreased remarkably following the economic growth in Korea. As a result, this age group has a high risk for HAV infection paradoxically, and over 1500 cases of clinically overt hepatitis A occurred in 1998. Human isolates of hepatitis A virus (HAV) are categorized within four genotypes (I, II, III, and VII). In some geographic regions, closely related isolates cluster, suggesting endemic spread of the virus, while in other regions multiple genotypes circulate. Virtually no data are available with regard to the genetic relatedness of Korean strains of HAV.

METHODS AND RESULTS

A 168 base pair segment encompassing the putative VP1/2A junction of the HAV genome was amplified by RT-PCR and sequenced in sera of 18 Korean patients with a sporadic form of acute hepatitis A. Pairwise comparisons of the nucleic acid and amino acid sequences of 18 Korean isolates with one another revealed that the Korean isolates showed > 94.6% and > 96.4% identity, respectively. All of the 18 Korean isolates clustered within genotype IA, irrespective of the geographic locations and the time that hepatitis occurred. Unique amino acid sequence changes that had never been reported in genotype IA were found in nine of the 18 isolates. These changes were Gln-->Ser and Lys-->Arg in 2A-19 and 2A-10 amino acid positions.

CONCLUSION

The presence of single genotype and unique mutations may be related with the circulation of endemic HAV over a long period of time in Korea.

Specific inhibition of transforming growth factor-beta2 expression in human osteoblast cells by antisense phosphorothioate oligonucleotides

To elucidate the role of endogenous transforming growth factor (TGF)-beta2 on human osteoblast cell, antisense phosphorothioate oligonucleotides (S-ODNs) complementary to regions in mRNA of TGF-beta2 were synthesized and examined their effects on TGF-beta2 production and cell proliferation in a human osteoblast cell line ROS 17/2. Antisense S-ODNs were designated for three different target regions in the mRNA of TGF-beta2. Among several antisense S-ODN analyzed, an oligonucleotide (AS-11) complementary to the translation initiation site of mRNA of TGF-beta2 demonstrated a selective and strong inhibitory effect on TGF-beta2 production in osteoblast cells. Other antisense S-ODNs which were designated for other regions in mRNA of TGF-beta2 and one- or three-base mismatched analogs of AS-11 showed little or much less antisense activities than AS-11. Therefore, the most effective target site in mRNA of TGF-beta2 is at the initiation codon region. The antisense effects of AS-11 were observed without reduction of levels of mRNA of TGF-beta2. Furthermore, the inhibition of TGF-beta2 expression by antisense S-ODN appeared to enhance cell proliferation, demonstrating the growth inhibitory effect of autocrine TGF-beta2 in osteoblast cells.

Prenatal fumonisin (FB1) treatment in rats results in minimal maternal or offspring toxicity

To investigate the neurobehavioral and developmental effects of the mycotoxin, FB1, Sprague-Dawley rats were treated with FB1 on gestational days 13-20. In Experiment 1, FB1 was obtained from culture material and pregnant rats were gavaged with 0, 0.8 or 1.6 mg/kg. In Experiment 2, pregnant rats were gavaged with purified FB1 at doses of 0, 1.6 or 9.6 mg/kg. Offspring were evaluated on a battery of behavioral tests as well as measures of whole and regional brain weight. There were no effects on maternal weight gain, reproductive outcomes, or offspring body weight through adulthood in either experiment. Complex maze performance, open field and running wheel activity were not altered by prenatal FB1 treatment. In Experiment 2, acoustic startle response was depressed at two ages during the first or second block of 9 trials in males treated with purified FB1. Females exhibited no such alterations. Play behavior at PND 33, but not PND 26, was increased in males prenatally treated with 9.6 mg/kg relative to those treated with 1.6 mg/kg. There were no substantive treatment effects on regional brain weight. These results suggest that doses of < or = 9.6 mg purified FB1/kg and/or < or = 1.6 mg FB1/kg obtained from culture material cause minimal maternal toxicity and produce few development functional alterations. In addition, potential FB1-related functional alterations were evident only in males providing further support for a mild sex-specific effect for fumonisin.

Fumonisin B1 in developing rats alters brain sphinganine levels and myelination

Objectives of this study were to test the hypothesis that fumonisin B1 (FB1) alters sphinganine (Sa) levels and myelin synthesis in the central nervous system of developing rats. FB1 (subcutaneous, 0.4 or 0.8 mg/kg/day) from postnatal days (PND) 3 to PND 12 resulted in a significant reduction of body weight gain and decreased survival rates. Both Sa levels and Sa/sphingosine (So) ratios were significantly increased in the brain of rats given 0.8 mg FB1/kg/day. To confirm the effect of limited nutrition on changes in the Sa levels and myelinogenesis, rats given 0.8 mg FB1/kg/day or treated by limited nutrition (temporary removal from dam during postnatal period) were compared to those in saline controls. Sa levels and Sa/So ratios were increased significantly in the 0.8 FB1-treated, but were not altered in the limited nutrition group. Myelin deposition in the corpus callosum and 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNP) activities were decreased significantly in both nutritionally limited and FB1-exposed rats. These data indicate that sphingolipid metabolism in the central nervous system of developing rats is vulnerable to FB1 exposure. The hypomyelination associated with FB1-treatment may be mediated by limited nutrition.

Cyclo(dehydroala-L-Leu), an alpha-glucosidase inhibitor from Penicillium sp. F70614

A diketopiperazine (1) has been isolated from the culture broth of Penicillium sp. F70614 and its structure has been determined to be cyclo(dehydroala-L-Leu) by various spectroscopic analyses. This compound selectively inhibited yeast alpha-glucosidase and porcine intestinal alpha-glucosidase with IC50 values of 35 and 50 microg/ml, respectively. However, it did not show significant inhibitory effects against almond beta3-glucosidase, Aspergillus alpha-galactosidase, Escherichia coli beta-galactosidase and jack bean alpha-mannosidase.

Human brain GABA transaminase tissue distribution and molecular expression

Human brain gamma-aminobutyrate transaminase is differentially expressed in a tissue-specific manner. mRNA master dot-blot analysis for 50 different human tissues, including different brain regions and fetal tissues, provided a complete map of the tissue distribution. Genomic Southern analysis revealed that the gamma-aminobutyrate transaminase gene is a single copy, at least 15 kb in size. In addition, human brain gamma-aminobutyrate transaminase cDNA was expressed in Escherichia coli using a pGEX expression vector system. Catalytically active gamma-aminobutyrate transaminase was expressed in large quantities and the purified recombinant enzyme had kinetic parameters that were indistinguishable from those isolated from other mammalian brains. The human enzyme was inactivated by a well-known antiepileptic drug vigabatrin. Values of Ki and kinact were 1 mM and 0.35 min-1, respectively. Results from inactivation kinetics suggested that human gamma-aminobutyrate transaminase is more sensitive to the vigabatrin drug than the enzyme isolated from bovine brain.

Detection of hepatitis A viral RNA in sera of patients with acute hepatitis A

BACKGROUND AND AIMS

The Detection of hepatitis A virus (HAV) is important for diagnosis and epidemiological studies of hepatitis A. The polymerase chain reaction (PCR) technique is a sensitive test to detect HAV-RNA in specimens. The aims of the present study were to clarify the detection rate of serum HAV-RNA by PCR and the natural history of HAV viraemia, and to determine the correlation between viraemia and the clinical characteristics in patients with acute hepatitis A.

METHODS

Hepatitis A virus RNA was tested in 74 serum samples which were serially collected from 27 patients with acute hepatitis A. A nested reverse transcription (RT)-PCR for HAV-RNA was performed with primer sets located at the VP1 region of the HAV genome and the PCR products were electrophoresed on a 1.5% agarose gel.

RESULTS

Hepatitis A virus RNA was found in 18 of 27 (67%) patients with hepatitis A. There were no significant differences between groups positive and negative for HAV-RNA in clinical and laboratory data, except the time interval between clinical onset and initial serum sampling for RT-PCR (10 +/- 6 vs 19 +/- 14 days) and the alanine aminotransferase (ALT) level at initial serum sampling for RT-PCR (1436 +/- 1416 vs 518 +/- 432 IU/L). The mean duration of HAV viraemia was 30 +/- 19 days (range, 5-59 days). The duration of HAV viraemia and duration of abnormal ALT levels from clinical onset were positively correlated (r = 0.685, P = 0.007).

CONCLUSION

In conclusion, HAV-RNA RT-PCR is a useful tool to detect HAV viraemia and to study the molecular epidemiology of HAV infection.

Human pyridoxal kinase: overexpression and properties of the recombinant enzyme

Pyridoxal kinase catalyses the phosphorylation of the vitamin B6. A human brain pyridoxal kinase cDNA was isolated, and the recombinant enzyme was overexpressed in E. coli as a fusion protein with maltose binding protein (MBP). Pure pyridoxal kinase exhibits a molecular mass of about 40 kDa when examined by SDS-PAGE and FPLC gel filtration. The recombinant enzyme is a monomer endowed with catalytic activity, indicating that the native quaternary structure of pyridoxal kinase is not a prerequisite for catalytic function. Zn2+ is the most effective divalent cation in the phosphorylation of pyridoxal, and the human enzyme has maximum catalytic activity in the narrow pH range of 5.5-6.0. The Km values for two substrates pyridoxal and ATP are 97 microM and 12 microM, respectively. In addition, the unfolding processes of the recombinant enzyme were monitored by circular dichroism. The values of the free energy change of unfolding (AGo = 1.2 kcal x mol(-1) x K(-1)) and the midpoint transition (1 M) suggested that the enzyme is more stable than ovine pyridoxal kinase against denaturation by guanidine hydrochloride. Intrinsic fluorescence spectra of the human enzyme from red-edge excitation and fluorescence quenching experiments showed that the tryptophanyl residues are not completely exposed and more accessible to neutral acrylamide than to the negatively charged iodide. The first complete set of catalytic and structural properties of human pyridoxal kinase provide valuable information for further biochemical studies on this enzyme.